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1543685000GoldStandard FCPS:Medicine & Allied24April 2019 Morning (Errors and omissions excepted)Cram StatementsHCO3 absorption in nephron?---->PCT and collectingAbout 85 to 90% of the filtered?bicarbonate?isreabsorbed?in the proximal tubule and the rest isreabsorbed?by the intercalated cells of the distal tubule and collecting ducts function of progesterone is?---->Maintain endometrium thicknessmost important functions?is to cause the?endometrium?to secrete special proteins during the second half of the menstrual cycle, preparing it to receive and nourish an implanted fertilized eggrigidity of facial muscle with tremors in hands. The lesion is in ?---->Substantia nigraThe cardinal motor features of PD—described as the “classical triad”—include resting tremor, “cogwheel” rigidity, and bradykinesiaCBC showed MCV & MCHC low, Hb 6.8. type?---->Iron deficiency anemiaIron deficiency anemia signs and symptoms may include: Extreme?fatigue.Weakness. Pale skin. fast heartbeat or shortness of breath. Headache, dizziness . Inflammation or?soreness?of your tongue. Brittle nails. Labs show Microcitic hypochormic red blood cellson psychiatric medications develops agitation and visual impairment. causing is?---->ThioridazineCommon?side effects of thioridazine?include: dizziness , agitation, restlessnessBeta adrenergic stimulation causes?---->Glycogenolysisβ receptors?couple to Gs, and increases intracellular cAMP activity, resulting in e.g. heart muscle contraction, smooth muscle relaxation and?glycogenolysisMOA of H2 inhibitor/cimetidine ---->Decrease acidity and volume of acid secretionMOA: Competitive antagonist at the H2 receptor. Blocks H2 receptors in parietal cells which suppresses basal and meal-stimulated acid secretion in a dose-dependent manner.Effect of Warfarin is increased by?---->CimetidineCimetidine?potentiates the anticoagulant?effect?of?warfarin?sodiumsudden purposeless jerky movements of his arms . Lesion is in?---->Caudatesudden movements?(i.e., motor tics) and/or vocalizations (i.e., vocal ...?patients?maydevelop?involuntary?movements?following injury to head of?the caudate, and internal capsule?Sarcoidosis is diagnosed ---->Granuloma with asteroidThe granulomas are typically 'naked' with few surrounding lymphocytes and a rim of mild dermal fibrosis. Asteroid bodies are star shaped cytoplasmic inclusionsHX of Cough, Histology shows granuloma with caseous necrosis. The hilar lymph sign chest x-ray is normal.diagnosis?---->Histoplasmosismine worker with tuberculin test positive with hilar lymphadenopathy. Diagnosis is?---->SilicosisSilicosis, a preventable occupational lung disease, is associated with various diseases, including tuberculosis (TB). There is an increased lifelong risk for lung tuberculosis even if exposure to silica dust ceasesCabergoline acts on ---->D2 agonistCabergoline?an ergot derivative, is a potent dopamine receptor?agonist?on D2 receptors. ..tyre factory worker, exposed to hydrocarbons. Risk of---->Bladder Ca??bronchopulmonary segment:---->Supplied by bronchus segment and tertiary part of pulmonary arteryA?bronchopulmonary segment?is a?portion of lung supplied?by a specific segmental?bronchus?and?arteries. These?arteries?branch from the?pulmonary?andbronchial arteries,the amount of co2 dissolved in plasma at45mmHg is?---->0.027guyton & hall: 2.7% (recommended) |BUT| carbon dioxide?diffuses from peripheral tissues into the bloodstream, approximately 10% of it remains?dissolved?in the?plasma, or the extracellular fluid matrix of the blood, to a partial pressure of about?45 mmHg. Source: || primary amenorrhea, webbed neck, karyotype show?---->45X0Turner syndrome?is a chromosomal condition that affects development in females. The most common feature of?Turner syndrome?is short stature,?webbed neck, wide carryng angle and streaked ovaries. Karyotype shows 45-XO chromosomes Celts of simple columnar epithelium are connected to each other by?---->Tight junction, adherent junction and desmosomethey are confined to the basolateral (basal and lateral) surfaces of the cell, ... Thetight junctions?between?epithelial?cells are thought to have both of these roles. ...?Adherens Junctions Connect?Bundles of Actin Filaments from Cell to Cell ... Through?desmosomes, the intermediate filaments of adjacent cells are?linked Muscles:---->Aponeurosis is fibrousAn?aponeurosis?is a type or a variant of the deep?fascia, in the form of a sheet of pearly-white?fibrous?tissue that attaches sheet-like?muscles?needing a wide area of attachment.? structure is continuous with internal spermatic fascia?---->Fascia transversalis. The transversalis?fascia?iscontinuous?with the?internal spermatic fascia.Appendicular artery is a branch of?---->IleocolicVermiform Appendix is supplied by appendicular artery which is a branch of ileo- colic artery (Abranch of?superior mesenteric artery?which is the artery of mid- gutAnterior intercostal arteries are branches of?---->Internal thoracic arteryhe?anterior intercostal branches of internal thoracic artery?supply the upper five or six?intercostal?spacesPulmonary valve opens when right ventricular pressure exceeds?---->8 mmHgThe valve is opened by the increased blood pressure of the ventricular systole (contraction of the muscular tissue), pushing blood out of the heart and into the artery i.e 8mmhgInjury causing hyperextension of neck and damage to cervical cord is by?---->Pain on opposite side c LMN lesion of upper limbHyperextension of the neck is an injury caused by an abrupt forward then backward movement of the head and neck which presents as pain on opposite side due to LMN short left leg rotated laterally. Cause is?---->Femur neck fractureThe most common types of hip fractures are: Femoral neck fracture. A femoral neck fracture happens 1 to 2 inches from your hip joint.COPD patient, 02 pressure at 11cm of water by PEEP for 24 hrs would cause?---->Pneumothoraxprimary amenorrhea. On U/S absent ovaries & uterus were seen. cause is?---->Testicular feminizing syndromeTesticular feminizimg syndrome patients are sterile, they cannot bear children, USG shows absent ovaries and uterus, present with primary amenorrhea sore throat. received antibiotic, resolved it, following 2 weeks, later developed generalized body Edema, cause?---->Acute post streptococcal glomerulonephritisHematuria, Hypertension, Edema and decreased urine output preceded by sore throat in children is a classical presentation of acute post streptococcal glomerulonephritis investigation for myasthenia graves is?---->Anti-acetylchoiine receptor AbThe main test for myasthenia gravis is a blood test to look for a type of antibody (produced by the immune system) that stops signals being sent between the nerves and muscles. A high level of these antibodies usually means you have myasthenia gravis.toxin produced by streptococcus pneumonia is?---->Streptolysin Ostreptolysin O is a hemolytic factor produced by group A beta hemolytic streptococci and it is the most prominent toxin as ASO titers are used as a diagnostic criteriasuffering from primary syphilis. sample is taken from?---->Genital soressmall, open painless sore or ulcer (chancre) on mouth and genitalia is a lesion of primary syphilis least dilatable part is this?---->Membranous partThe membranous urethra or intermediate part of male urethra is the shortest, least dilatable, and, with the exception of the urinary meatus, the narrowest part of the urethraACE inhibitor to controll bp result in decreased blood supply to brain? Cause?---->Decrease sympatheticACE Inhibitors Down regulate sympathetic adrenergic activity by blocking the facilitating effects of angiotensin II on sympathetic nerve release and reuptake of norepinephrine. Labs shows PT normal, APTT raised BT raised. Diagnosis?---->Von Willebrand diseaseThe aPTT is mildly prolonged in approximately 50% of patients with vWD. The prolongation is secondary to low levels of FVIII because one of the normal functions of vWF is to protect FVIII from degradation. The PT should be within reference ranges. BT indicated platelet disorderA lady had labor at home in village. Her PT & APTT were prolonged. Most likely cause is?---->DICLaboratory findings suggestive of DIC consist of a low platelet count, elevation of the D-dimer and fibrinogen concentrations, and prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT).Thiazide diuretics causes?---->HypokalemiaThiazide diuretics reduces potassium concentration in blood through two indirect mechanisms: inhibition of sodium-chloride symporter at distal convoluted tubule of a nephron and stimulation of aldosterone that activates Na+/K+-ATPase at collecting duct.Labs show APTT prolong. PT & BT normal. Diagnosis?---->HemophiliaHemoglobin/hematocrit: Normal or low. Platelet count: Normal. Bleeding time and PT: Normal. APTT: Significantly prolonged in severe hemophilia, . CBC picture shows presence of atypical lymphocytes. important test in this setting is?---->Monospot testMononucleosis spot test. The mononucleosis spot test looks for 2 antibodies in the blood. These antibodies appear during or after an infection with the virus that causes mononucleosis, or mono. Infectious mononucleosis causes a sore throat, enlarged lymph nodes, and fatigue. runner started sweating profusely and complained confusion, cause?---->Heat exhaustionThe most common signs and symptoms of heat exhaustion include: Confusion Dark-colored urine (a sign of dehydration) Dizziness Fainting Fatigue Headache Muscle or abdominal cramps Nausea, vomiting, or diarrhea Pale skin Profuse sweating Rapid heartbeat Epistaxis bleeding from the lateral wall of nose, artery involved is?---->Sphenopalatine arteryThe sphenopalatine artery is the artery responsible for the most serious, posterior nosebleeds (also known as epistaxisin peptic ulcer disease,. Analgesia of choice should be?---->AcetaminophenAcetaminophen (Tylenol?) is NOT an NSAID and is therefore the preferred non-prescription treatment for pain in patients at risk for peptic ulcer disease.Cimetidine may prolong the prothrombin time and causes bleeding in with warfarin. ---->Decreasing the hepatic clearance of warfarincimetidine caused an increased prothrombin time in patients receiving warfarinpregnant lady RH positive and husband RH negative. ---->No need to worryRH symptoms occur when the mother is Rh negative and the father is Rh positive resulting in RH positive baby so no risk in above mentioned scenarioSemi-circular canals in cortex of ear are maximally stimulated?---->Doing cartwheelPosterior semicircular canal hair cells are most commonly stimulated during a cartwheel while anterior ones during a saumersaulthepatosplanomegaly with fever & chills. Labs show Giemsa stain positive. Diagnosis?---->Plasmodiumfindings in malaria may include fever, weakness, pallor, jaundice, and perspiration. Other findings on physical exam are tachycardia, tachypnea, splenomegaly, and hepatomegaly.Conduction system of heart is located in?---->Sub endocardiumThe bundle branches run along the subendocardium of the interventricular septum and free ventricular walls and give rise to Purkinje fibers that supply the myocardium in a subendocardial-to-epicardial directionSA node acts as a heart pacemaker because of?---->Generates impulses at faster rateThe SA node is sometimes referred to as the heart's "natural pacemaker" because it initiates impulses for the heartbeat at a faster rate as Compared to AV nodes and bundle branchesasthmatic comes to ER with dyspnea respiratory rate 30---->Hysterical hyperventilationpatients with hysterical hyperventilation often present with sudden onset of dyspnea, chest pain and neurological symptoms after a stressful event as hyperventilation causes CO2 level to drop and further aggravates conditionGIT completely denervated, the effect on Gl movement will be?---->Have little effect on the resting ratfe of intestinal peristalsisGIT denervation in the long term has little effect on rate of intestinal peristalsis Pleura ruptured in pneumothorax, ---->Inward lung collapse and outward chest wall springair builds up, pressure inside the pleural space increases and causes the lung to collapseparesis of limbs due to UMN injury. Site ---->Corticospinal tract and corticobulbar tractThe nerves in the CNS which carry the impulses for movement are known as upper motor neurons (UMN). The primary tract which carries signals for voluntary movement is known as the pyramidal tract. The pyramidal tract divides further into the corticospinal tract and the corticobulbar tract. blood supply of scalp is from?---->External carotid artery External carotid artery supplies head and neck external to craniumLumbar triangle is anteriorly related to posterior part ---->External obliqueThe margins of the inferior lumbar (Petit's) triangle are composed of the iliac crest inferiorly and the margins of two muscles – latissimus dorsi (posteriorly) and external abdominal oblique (anteriorly parameters is decreased during moderate exercise?---->Total peripheral resistance (TPR)Indeed, during dynamic exercise at maximal levels, total peripheral resistance is less than one-half its value at rest. ... The decrease in total peripheral resistance is the result of decreased vascular resistance in skeletal muscle vascu- lar beds, leading to increased blood flow.rheumatic mitral stenosis developed fever, lafter tooth extraction. organism ?---->Strep viridianscases of subacute bacterial endocarditis, the causative organism (streptococcus viridans) needs a previous heart valve disease to colonize. Other include mutants, mitischaracteristics of IgM?---->It is the largest moleculeIGM is the largest molecule, highest avidity of all immunoglobulins, is a better agglutinin Cerebellum is connected to midbrain via?---->Superior cerebellar pedunclethe?superior cerebellar peduncle?(brachium conjunctivum) is a paired structure of white matter that?connects?the?cerebellum?to the?midbrainStructure closest to crus cerebri is?---->Substantia nigraStructure closest to crus cerebri is Substantia nigra profuse bleeding from posterior wall of mastoid antrum. Source of bleeding?---->Sigmoid sinusThe location of the?sigmoid sinus?within the?mastoid?cavity is quite variable. So in surgery, it might easily provoke a?massive bleeding? increase the Gastric motility?---->GastrinGastrin is?a peptide hormone that stimulates secretion of?gastric?acid (HCl) by the parietal cells of?the stomach?and aids in?gastric motility.Primordial germ cells of yolk sac migrate to gonadal ridges in which week?---->6lh weekThe?primordial germ cells?wander out of the?yolk sac?wall, along the vitelline and the dorsal mesentery, into the?gonadal ridge. They reach this structure in the 6thweek.Climbing fiber originate from?---->Inferior olive nucleusClimbing fiber?is shown originating from the inferior olive (green).?Climbing fibers are?the name given to a series of neuronal projections from the inferior olivary nucleus located in the medulla oblongata.PTH action on renal tubules?---->Inhibit phosphate absorption in PCTPTH?reduces the reabsorption of phosphate from the proximal?tubule?of the?kidney, which means more phosphate is excreted through the urine.?Damage in the right somatosensory causes?---->Loss of crude touch of left sidesomatosensory losses?in his?left hand?include ...?symptoms?are ipsilesional (i.e., involve?damage?to the?right?half of the spinal cord, ... touch and proprioception, but no?loss?of pain, temperature or?crude touch?sensitivity. Aphasia & Facial nerve palsy on same side. Which artery is most likely blocked?---->Middle cerebral arteryThe MCA is by far the largest cerebral?artery?and is the vessel?most?commonly affected by cerebrovascular accident. containing IgE receptors and dense basophilic granules with histamine are?---->BasophilsThey?contain?cytoplasmic?granules?with similar?histamine?levels per?cell?as mast?cells. In contrast, the amount of tryptase in?basophils?is less than 1% of that in mast?cells. Cross-linking of the FcεRI by?IgE-antigen complexes causes?basophil?degranulation and mediator release, particularly of?histamine.metallic taste The most probable medication it is?---->MetforminMetformin (biguanide)?should be the first-line drug for managing type 2 diabetesPrimary TB granuloma complex is?---->Granuloma with surrounding lymphaticThese lesions are characteristic of the first infection?tuberculosis?that heals to form a Gohn?complex?with calcified?granulomas?in the lung and hilar lymph nodes.Homonymous hemianopia is due to lesion in?---->Optic tractVascular and neoplastic (malignant or benign tumours)lesions?from the?optic tract, to visual cortex can cause a contralateral?homonymous hemianopsia.Tumor involvement of submental and submandibular lymph node?---->TongueThe afferents of the submandibular glands drain the medial canthus, the cheek, the side of the nose, the upper lip, the lateral part of the lower lip, the gums, and the anterior part of the margin of the tongue. Efferent lymph vessels from the facial and submental lymph nodes also enter the submandibular glands. low amplitude QRS complex is?---->Old Ml;ow voltage may be present in the following situations:Chronic obstructive pulmonary disease, or COPD, Obesity, Pericardial effusion, Severe hypothyroidism, Massive myocardial damage/infarction, Infiltrative/restrictive diseases such as amyloid cardiomyopathyECG of atrial fibrillation?---->Irregular R-R intervalThe hallmark of?atrial fibrillation?is absence of P-waves and an irregularly irregular (i.e totally irregular) ventricular rateS3 sound is produced by?---->Rapid filling of ventricleThe third?heart sound?is?caused?by a sudden deceleration of blood flow into the left ventricle from the left atrium.Maximum aortic pressure is during phase of cardiac cycle?---->Slow ejectionstage?to the?maximumvolume occurring?in?the "Atrial systole" sub-stage.Mechanism of reduction in size of organ in chemotherapy is---->ApoptosisApoptosis?is an orderly?process?in which the cell's contents break down and are packaged into small packets of membrane for “garbage collection” by immune cells.Regarding S2:---->Isovolumetric relaxationWhen the intraventricular pressures fall sufficiently at the end of phase 4, the aortic and pulmonic valves abruptly close (aortic precedes pulmonic) causing the second heart sound (S2) and the beginning of?isovolumetric relaxationParasympathetic---->Greater splanchnicThe thoracic,?lumbar?and sacral?splanchnic?nerves are sympathetic in function while the pelvic?splanchnic?nerves are?parasympatheticType of joint present in intervertebral disc is?---->SymphysisEach?disc forms?a fibrocartilaginous?joint?(a?symphysis), to allow slight movement of the vertebrae, to act as a ligament to hold the vertebrae together, and to function as a shock absorber for the spine.Calculate GFR in CKD for transplant or dialysis?---->Creatinine clearanceRenal function tests monitor need for dialysis (Serum urea and creatinine). Hip joint is ---->Interiorly to oburator externusmuscle originates from the upper part of the inferior pubic ramus from where it runs downwards and laterally. ... The external obturator muscle acts as the lateral rotator of the hip joint.Stratified squamous epithelium is in---->Palatine tonsilThe?palatine tonsil?is composed of lymphoid tissue with epithelial cells of keratinized?stratified squamous epitheliumBeriberi is caused due to deficiency of?---->ThiamineBeriberi is a disease caused by a vitamin B-1 deficiency, also known as thiamine deficiency. There are two types of the disease: wet beriberi and dry beriberi. Wet beriberi affects the heart and circulatory system cause of acquired thrombosis is?---->Anti-phospholipid antibody syndromeThe antiphospholipid syndrome is a relatively common acquired cause of venous thrombosis. ... Most antiphospholipid antibodies are directed against several phospholipid-binding plasma proteins. The most common antigens are β2-glycoprotein I and prothrombinTall T waves with wide QRS complex and absent p waves. Diagnosis?---->HyperkalemiaEarly changes of hyperkalemia include tall, peaked T waves with a narrow base, best seen in precordial leads ; shortened QT interval; and ST-segment depressionput on warfarin, first factor to be decreased?---->Factor 7Warfarin decreases blood clotting by blocking an enzyme called vitamin K epoxide reductase that reactivates vitamin K1. Without sufficient active vitamin K1, clotting factors II, VII, IX, and X have decreased clotting ability.Cryptococcus neoformans. treatment ---->Amphotericin BStandard treatment of CM with amphotericin B and flucytosine CSF has---->Decrease glucose than plasmaThe CSF/serum glucose ratio, also known as CSF/Blood glucose ratio, is a measurement used to compare CSF glucose and blood sugar.CSF contains 2/3rd of normal plasma glucose.M band in multiple myeloma is produced by ---->Plasma cellsThe M-Band is a serum marker for plasma cell dycrasias and Waldenstr?m macroglobulinemiaMononuclear phagocytosis originates from precursor cells in?---->Bone marrowThe spleen is the largest unit of the mononuclear phagocyte system. The monocyte is formed in the bone marrow and transported by the blood; it migrates into the tissues, where it transforms into a histiocyte or a macrophage. marker of neural tube defects is?---->AFPAn AFP test is a routine screening test that’s given to expectant mothers between the 14th and 22nd weeks of their pregnancy.It is the most specific marker of neural tube defects. produced by the action of lipoxygenase on arachidonic acid, ---->Leukotriene 3&4Leukotrienes are a family of ecosanoid inflammatory mediators produced in leukocytes by the action of arachidonic acid and the essential fatty acid ecosapentaenoic acid by the enzyme lipooxygenaseheight altitude complains of---->Respiratory alkalosisAs the oxygen tension of inspired air falls with increasing altitude in normal subjects, hyperventilation ensues. This acute respiratory alkalosis, induces increased renal excretion of bicarbonate, returning the pH back to normal, giving rise to compensated respiratory alkalosis or chronic hypocapnia. complication of AIDS? ---->Pneumocystis carinipneumocystis carini is one of the most frequent and severe opportunistic infection in people with AIDS.Cushiig's syndrome character---->Abdominal striaeSkin striae due to hypercortisolism are often wide and purple, which contrasts with the narrow and pale or pink striae of rapid weight gain (5). Facial acne and hirsutism are attributed to increased adrenal androgen and/or cortisol secretionAcute Pulmonary congestion due to mitral stenosis. in alveoli?---->MacrophagesThis condition occurs due to the deposition of hemosiderin-laden macrophages in lungs as a result of repeated alveolar hemorrhage that subsequently leads to the development of pulmonary fibrosis common feature of autoimmune disease is?---->ArthritisThe most common autoimmune diseases in women are: Rheumatoid arthritis, a form of arthritis that attacks the joints. if the centromere gets divided transversely instead of vertically then it results in?---->IsochromosomeAn isochromosome is created when the centromere is divided transversely, or perpendicular to the long axis of the chromosome. ... Misdivision of the centromere can also produce monocentric isochromosomes, but they are not as common as dicentric isochromosomes.in appendicitis. Pain will be mediated by?---->Bradykinin and prostaglandin EIn any inflammatory condition leukocytosis is mediated by prostaglandin E and bradykinins which are the inflammatory mediators.male with renal artery obstruction and resultant increased renin secretion will cause?---->Angiotensin 2 induced T test is used?---->To compare 2 categories/groupsA t-test is a type of inferential statistic used to determine if there is a significant difference between the means of two groups, which may be related in certain features. The t-test is one of many tests used for the purpose of hypothesis testing in statistics Regeneration of liver is ---->HyperplasiaCompensatory hyperplasia is the proliferation of cells while they maintain their differentiated structure and function. The classic example is hepatocyte regeneration in injured liver pregnant women presented with hypertension. The drug of choice will be?---->MethyldopaDuring long term use in pregnancy, methyldopa does not alter maternal cardiac output or blood flow to the uterus or kidneys, and for all these reasons is generally considered the agent of choice for chronic blood pressure control in pregnancy. Albumin does not get freely filtered in glomeruli due to?---->Negative charge of particleThe glomerular filtration barrier bears electrostatic charge and shows not only size- but also charge-selective properties thus albumin being negatively charged is not filtered.reflex for defecation is?---->RectoanalThe rectoanal inhibitory reflex (RAIR) (also known as the anal sampling mechanism, anal sampling reflex, rectosphincteric reflex, or anorectal sampling reflex) is a reflex characterized by a transient involuntary relaxation of the internal anal sphincter in response to distention of the rectumpositive feedback is?---->Child birthImage result for positive feedback childbirth Image result for positive feedback childbirth View all A positive feedback loop maintains the direction of the stimulus and possibly accelerates it. ... Another example of positive feedback is uterine contractions during childbirth. The hormone oxytocin, made by the endocrine system, stimulates the contraction of the uterus Antidote of warfarin toxicity is?---->Vit KWarfarin is a vitamin K antagonist used as an anticoagulant used for treatment and prevention of a variety of coagulopathic and thromboembolic disorders.It is given to patients taking warfarin on a long term basis hypothalamus- hypophyseal portal system in:---->Anterior pituitaryThe hypophyseal portal system is a system of blood vessels in the microcirculation at the base of the brain, connecting the hypothalamus with the anterior pituitary. vessel accompanying LAD in anterior interventricular groove. vessel is?---->Great cardiac veinThe largest vein, termed the great cardiac vein, accompanies the anterior interventricular artery, turning beneath the left atrial appendage to join the coronary sinus. MOA of IV potassium treatment---->Na-K pumpsThe sodium potassium pump regulates extracellular potassium levels by pumping sodium out of cells and allowing potassium to flow back into cells.pregnant lady diagnosed as mitral stenosis with atrial fibrillation. drug should she ---->Beta blockerBeta blockers are a first line medication for hypertension during pregnancy and maternal cardiac conditions because they do not increase risk for fetal cardiac anomalies.Blood supply to the upper 1/3 of the esophagus is ---->Inferior thyroid arteryThe upper parts of the esophagus and the upper esophageal sphincter receive blood from the inferior thyroid artery, the parts of the esophagus in the thorax from the bronchial arteries and branches directly from the thoracic aorta Acetaminophen undergoes ---->GlucuronidationAcetaminophen glucuronide is a natural human metabolite of Acetaminophen generated in the liver by UDP glucuonyltransferase. Glucuronidation is used to assist in the excretion of toxic substances, drugs or other substances that cannot be used as an energy source. locally malignant tumor is?---->AmeloblastomaAmeloblastoma. Ameloblastomas are locally aggressive jaw tumors with a high propensity for recurrence Test dose of Edrophonium relieves symptoms. reasonable approach ---->Increase Neostigmine doseNeostigmine works by slowing the breakdown of acetylecholine when it is released from nerve endings in myasthenia gravis.Poitive endrophonium test confrims the pathology and neostigmine is the drug of choice . diabetic gastroparesis. best drug ---->MetoclopramideMetoclopramide is used for the symptomatic treatment of post-operative or chemotherapy-induced nausea and vomiting, gastroesophageal reflux disease and gastroparesis. Metoclopramide is generally started at a dose of 5–10 mg orally, 30 min before meals and at bedtime farmer presented with right lower lobe coin like mass, cause?---->AspergillosisA typical radiological finding of an aspergilloma is a solid, round or oval mass with soft-tissue opacity within a lung cavity, manifesting an “air crescent sign” without significant enhancement Testicular mass with mature cells and all 3 germ layers ---->TeratomaTeratomas are a form of germ cell tumor containing elements from all 3 embryonic germ layers, ie, ectoderm, endoderm, and mesoderm. ... A dermoid cyst (mature cystic teratoma) after opening the abdomen. During exercise, decreased blood flow to?---->KidneyThese alterations are coordinated by the sympathetic nervous system, which directs increased sympathetic outflow to the heart, resulting in increased cardiac output, and evokes baroreflex-mediated vasoconstriction in peripheral organs (e.g., kidneys, small and large intestines, and non-exercising skeletal muscles) Endocervical tissue partially lined by stratified squamous epithelium. This is due to?---->MetaplasiaMetaplasia is abnormal change in nature of a tissue ,It occurs in resposne to injury feature of Squamous Cell Ca is?---->Epithelial nest of keratinHistopathologically, squamous cell carcinoma cells show keratinization (in the form of keratin pearls or single cell keratinization) and/or intercellular bridges. ... The most common pattern is one of infiltrating nests of malignant squamous cells Staging is a method of determining?---->Degree of differentiationStages of Cancer. Staging helps describe where a cancer is located, if or where it has spread, and whether it is affecting other parts of the body. thyroid gland is enclosed in ---->Pretracheal fasciaIt spans between the hyoid bone superiorly and the thorax inferiorly (where it fuses with the pericardium). The trachea, oesophagus, thyroid gland and infrahyoid muscles are enclosed by the pretracheal fascia. Referred pain from the appendix will be in?---->?? UmbilicusIf you have appendicitis, you may feel sharp pain around your navel that eventually shifts to the lower right side of your abdomen. nerve injured in fracture of medial epicondyle of humerus is?---->Ulnar nerveMedial epicondyle fractures of the distal humerus constitute 10%–15% of pediatric elbow fractures. These injuries frequently occur in association with intra-articular incarceration of the fracture fragment, elbow dislocation, ulnar nerve insult child develops proteinuria of 3.5g/day. the mechanism for development of edema?---->Decreased plasma colloid pressureLower serum oncotic pressure causes fluid to accumulate in the interstitial tissues. Sodium and water retention aggravates the edema. Vasodilatation and hypotension are features of ---->SepticThe predominant hemodynamic feature of septic shock is arterial vasodilation. ... Diminished peripheral arterial vascular tone may cause blood pressure to be dependent on cardiac output, so that vasodilation results in hypotension and shock The most suitable donor for her will be?---->?? Identical twinidentical twins share the same genetic makeup and are the best donors for each other. Patient with hypoxia, PO2 55mmhg, Hb 16, no history of poisoning or blood loss. Diagnosis---->Hypoxic hypoxiaHypoxemic Hypoxia Low oxygen tension in the arterial blood (PaO2); due to the inability of the lungs to properly oxygenate the blood. Causes include hypoventilation, impaired alveolar diffusion, and pulmonary shunting.Dec hemoglobin as in anemia, carbon monoxide poisoning will not cause hyperoxia because?---->Arterial PO2 normalcarbon monooxide poisoning or methheamoglobin formation decreases two variables ,SO2 and CO2, where the PO2 remains normal and results in toxic hypoxemia. MOA of acetazolamide?---->Decreases hydrogen secretion and increase excretion of Na and KAcetazolamide inhibits carbonic anhydrase, an enzyme which is responsible for the small amount of active Na+ reabsorption in the proximal tubule in exchange for H+ secretion into the tubuleAnterior pituitary lobe surgery done, first lost?---->MenstruationGnRH stimulates anterior pituitary to secrete FSH and LH for causing follicular maturation and ovulation repectively.After surgery it results in loss of menstrual cycle. Derivative of Neural crest- is?---->Dorsal root gangliaThe neural crest is a migratory population of cells that produces many diverse structures within the embryo. Trunk neural crest cells give rise to such structures as the dorsal root ganglia (DRG) and sympathetic ganglia (SG), which form in a metameric pattern along the anterior-posterior axis of the embryo.Newly diagnosed cases is expressed as?---->IncidenceIncidence is the rate of new (or newly diagnosed) cases of the disease. It is generally reported as the number of new cases occurring within a period of time (e.g., per month, per year).Two-point discrimination increase by?---->Lateral inhibitionLateral inhibition is the ability excited neurones have to inhibit the activity of neighbouring neurones. This prevents the spread of an action potential laterally. The result of this is an increased contrast in excitation between neighbouring neurones, allowing increased sensory acuityincreases pancreatic secretion and releases Ca from sarcoplasm?---->CCKLateral inhibition is the ability excited neurones have to inhibit the activity of neighbouring neurones. This prevents the spread of an action potential laterally. The result of this is an increased contrast in excitation between neighbouring neurones, allowing increased sensory acuityPleomorphism, Rete ridges, loss of polar ity and increased nuclear to cytoplasmic ratio. What is the diagnosis?---->Verrucous CAIn optimally sampled material, the histology of verrucous carcinoma includes a papillary or verrucous surface epithelium with marked keratosis composed of cytologically bland squamous epithelium and subtle, pushing infiltration of the underlying dermis. A heavy inflammatory cell inifltrate may be present in the stroma.Hormones for lacto genesis is?---->Oxytocin, prolactin and cortisolThe role of all the following hormones in lactogenesis are described: prolactin; adrenocorticotropin (ACTH, which stimulates glucocorticoid secretion); estrogens; placental lactogens. Maintenance of intense lactation also depends on a complex of hormones. Prolactin seems to be the most important hormone at this stage of the processCarpal tunnel syndrome, movement of thumb is affected?---->OppositionCarpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the mon site of fertilization is?---->?? Uterine tubesThe ampulla is the third portion of the fallopian tube. It is an intermediate dilated portion, which curves over the ovary. It is the most common site of human fertilization. ECG shows S1, Q3, T3. appropriate test ---->?? Gallium scanPulmonary edema is a condition caused by excess?fluid?in the lungs. ...?Pink, frothy sputum when you cough and breathlessness. Posterior thyroid is spared to avoid damage to?---->?? Parathyroid glandA subtotal thyroidectomy is typically defined as the removal of most of the gland, sparing about 2 g from the posterior portion bilaterally, because this might minimize the risk of recurrent laryngeal nerve (RLN) damage, hypothyroidism, and hypoparathyroidismin ligation of Superior thyroid artery there is increased risk of damage to ---->External laryngeal nerveThis artery must be ligated at the thyroid when conducting a thyroidectomy. ... Furthermore, the external laryngeal branch of the superior laryngeal nerve courses in close proximity to the superior thyroid artery, making it at risk for injury during surgeryIV B12 is used in---->ileal resectionRetention of terminal ileum tends to preserve vitamin B12 absorption capacity. Thus, if more than 60 cm of terminal ileum is removed, fat and B12 malabsorption are likely. The Schilling test is an indicator of the degree of terminal ileal dysfunctionInvestigation for Hashimotos thyroiditis?---->Anti-thyroglobulin and anti TPOAnti-thyroid antibodies (ATA) tests, such as the microsomal antibody test (also known as thyroid peroxidase antibody test) and the anti-thyroglobulin antibody test, are commonly used to detect the presence of Hashimoto's thyroiditisDrug of choice for traveler diarrhea is?---->?? NorfloxacinAntibiotics should be used to treat severe travelers' diarrhea. Azithromycin is preferred to treat severe travelers' diarrhea. Fluoroquinolones may be used to treat severe, nondysenteric travelers' diarrhea. Rifaximin may be used to treat severe, nondysenteric travelers' diarrhea.Heart muscles work as syncytium because of?---->?? Gap junctionsGap junctions are a specialized intercellular connection between a multitude of animal cell-types. They directly connect the cytoplasm of two cells, which allows various molecules, ions and electrical impulses to directly pass through a regulated gate between cellsNecrosis seen in heart and kidney?---->Coagulative necrosisCoagulative necrosis occurs primarily in tissues such as the kidney, heart and adrenal glands. Severe ischemia most commonly causes necrosis of this form. Liquefactive necrosis (or colliquative necrosis), in contrast to coagulative necrosis, is characterized by the digestion of dead cells to form a viscous liquid mass.thick mucoid sputum jelly like. Organism ---->KlebsiellaKlebsiella species pneumonia is classically associated with a cough productive of red currant-jelly sputum. Anaerobic infections often produce foul-smelling or bad-tasting sputumHypoxic vasoconstriction occurs in?---->LungHypoxic pulmonary vasoconstriction (HPV), also known as the Euler-Liljestrand mechanism, is a physiological phenomenon in which small pulmonary arteries constrict in the presence of alveolar hypoxia (low oxygen levels).Drug of choice for severe Clostridium difficile infection is?---->?? MetronidazoleOral metronidazole and oral vancomycin have similar efficacy rates in treating diarrhea caused by C difficile in mild to moderate infection but not in severe disease. ... For patients who are unable to tolerate oral medication, intravenous metronidazole is effective. the infection is highly transmissible?---->HBsAg +ve and HBeAg +veA positive surface antigen means HBV is. present and can spread to others. A. positive HBeAg confirms actively. replicating virus Common Dysplastic tissue---->SkinDysplasias on mainly microscopic scale include epithelial dysplasia and fibrous dysplasia of bone. Dysplasias on mainly macroscopic scale include hip dysplasia, myelodysplastic syndrome and multicystic dysplastic kidney.soldier posted at high altitude. PCV raised. Cause is?---->Secondary polycythemiaSecondary polycythemia is the overproduction of red blood cells. ... Red blood cells are constantly being manufactured in your bone marrow. If you move to a higher altitude where oxygen is rarer, your body will sense this and begin to produce more red blood cells after a few weeks diet contains mainly burgers. Blood picture shows macrocytic anemia, increase MCV. Deficency---->Folic acidMost folate-deficiency anemia is caused by a lack of folic acid in the diet. Leafy vegetables, citrus fruits, beans, and whole grains are natural sources of folic acid. Folate-deficiency anemia in pregnancy may cause a neural tube defect. This is when the brain or spinal cord doesn't develop normally.diabetic non-healing ulcer on the foot with sensory loss. ---->Angiopathy and neuropathyNon-healing ulcers commonly occur in people with diabetes, particularly if their blood sugar levels are too high or there is a history of smoking. ... It also leads to damage of much smaller blood vessels. This can damage nerves and leads to loss of sensation in the feet making the feet vulnerable to trauma.autoantibody for SLE is?---->ANASubtypes of antinuclear antibodies include anti-Smith and anti-double stranded DNA (dsDNA) antibodies (which are linked to SLE) and anti-histone antibodies (which are linked to drug-induced lupus). ... The anti-dsDNA antibody titers also tend to reflect disease activity, although not in all cases.Nucleus ambiguous lies in?---->MedullaThe nucleus ambiguus (literally "ambiguous nucleus") is a group of large motor neurons, situated deep in the medullary reticular formation named by Jacob Clarke.relation of jugular vein is with---->SternocleidomastoidThe internal jugular vein originates at the jugular foramen and descends to join the subclavian vein. In the mid to lower neck, it lies lateral and then anterolateral to the carotid artery. At the level of the thyroid cartilage, the vein lies deep to the sternocleidomastoid muscle.Cytokeratin are used for?---->Intermediate filamentThey are an important component of intermediate filaments, which help cells resist mechanical stress. Expression of these cytokeratins within epithelial cells is largely specific to particular organs or tissues. Thus they are used clinically to identify the cell of origin of various human tumors. Disorganized growth mass with mature tissue is known---->Hamartomahamartoma is a mostly benign,[2] local malformation of cells that resembles a neoplasm of local tissue but is usually due to an overgrowth of multiple aberrant cells, with a basis in a systemic genetic condition, rather than a growth descended from a single mutated cell (monoclonality), as would typically define a benign neoplasm/tumorcommon cardiacanomaly in Premature babies is?---->Patent ductus arteriosisThe most common heart problems premature babies experience are patent ductus arteriosus (PDA) and low blood pressure (hypotension). PDA is a persistent opening between the aorta and pulmonary artery.End arteries best example?---->Central Retinal arteryCentral artery of retina and labyrinthine artery of internal ear are the best examples of absolute end arteries. Central branches of cerebral arteries and vasa recta of mesenteric arteries. Arteries of spleen, kidney, lungs and metaphyses of long bonesRegarding Vibrio cholera: ---->Resistant to alkaline mediumThe cholera vibrios are Gram-negative, slightly curved rods whose motility depends on a single polar flagellum. Their nutritional requirements are simple. ... Vibrios are sensitive to low pH and die rapidly in solutions below pH 6; however, they are quite tolerant of alkaline conditions.The feature of a UMNL is?---->Hyper reflexesSigns of UMN disease usually include spasticity of the muscles (a stiffness and resistance to movement), brisk reflexes and a Babinski sign, (a reflex that is a sign of damage to the nerve paths connecting the brain to the spinal cord).causes chronic atrophic gastritis and duodenal ulcer?---->H. pyloriA bacterial infection by Helicobacter pylori or H. pylori, usually causes atrophic gastritis. ... Atrophic gastritis often starts when a person is a child. Left untreated, it will get worse over time and can lead to stomach ulcersprincipal body defense cells against tumors?---->NK cellsdefense against tumors immune system activates cell mediated and humoral immune responses, cell mediated immune system protects the body from itself by controlling cancerous cells, this includes activation of Cytotoxic T Lymphocytes, Natural Killer cells, Macrophages, Dendritic Cells, Lymphokines, etc., where as ...Function of enzyme? ---->Decrease activation energy of reactantsEnzymes allow many chemical reactions to occur within the homeostasis constraints of a living system. ... Many enzymes function by lowering the activation energy of reactions. By bringing the reactants closer together, chemical bonds may be weakened and reactions will proceed faster than without the catalyst.Balance between phosphorus and calcium is regulated by?---->PTHA hormone called parathyroid hormone (PTH) regulates the levels of calcium and phosphorus in your blood. When the phosphorus level is measured, a vitamin D level, and sometimes a PTH level, is measured at the same time. Vitamin D is needed for your body to take in phosphate.Insulin independent uptake occurs in?---->Hypothalamus/exercising muscleGUYTON = exercising muscle ||BUT|| FIRST AID: brainOsmotic pressure of solutes depends on?---->?? Increase no of particlesOsmotic pressure is a 'colligative' property, like freezing point depression, which means that it depends on the number of particles in solution but not on their chemical identity.G protein coupled receptor?---->cAMPIn the field of molecular biology, the cAMP-dependent pathway, also known as the adenylyl cyclase pathway, is a G protein-coupled receptor-triggered signaling cascade used in cell communication.Most potent salty taste is produced by?---->?? TaurineTaurine is a β-amino acid present in high concentrations in different tissues of mammals including all areas of the CNS. ... Taurine exerts its neuronal inhibitory effect through the activation of GABAA receptors (GABAAR) but with less affinity than the specific agonists of each receptoDOC for pulmonary edema is?---->Furosemidefurosemide (Lasix), to decrease the pressure caused by excess fluid in your heart and lungsFcpsWorld Facebook Group: Others & Get helped! Join our Whatsapp groupsFcps Anesthesia HYPERLINK "" \t "_blank" MD/MS: Pathology: gynae: Surgery: medicine: psychiatry: radiology: ophthalmology: Join Online classes contact: 031296846580-254000GoldStandard FCPS?Feb 2020 papers (recent updated)? Authentic most repeated papers.?MCQs with explanation and reference.?1 liner for rapid revision. (Cram them)? Mcqs with explanation and Ref.?Clear FCPS-1 in 1st Attempt (Dont miss chance)? Free Cash on DeliveryOrder at 03100220370 ................
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